Accuracy and precision of low-dose insulin administration

S. J. Casella, M. K. Mongilio, L. P. Plotnick, M. P. Hesterberg, C. A. Long

Research output: Contribution to journalArticle

Abstract

Objective. To determine the lowest dose of concentrated (U100) insulin that can be reproducibly delivered. Methods. A telephone survey was used to determine current practices in major pediatric hospitals regarding the administration of low doses of concentrated insulin. A sensitive gravitometric technique was used to determine the error in measurement of low doses of U100 insulin by pediatric nurses and parents of diabetic children. Results. A telephone survey revealed that doses as low as 0.5 or 1.0 U (5 to 10 μL) are routinely administered in pediatric hospitals. In our study of pediatric nurses, attempts to deliver 0.5, 1.0, and 2.0 U resulted in delivered doses of 0.975 ± 0.315, 1.638 ± 0.376, and 2.153 ± 0.435 U (mean ± standard deviation of the mean), respectively. The use of 0.3-mL syringes compared to 0.5-mL syringes did not improve accuracy or precision. Taken as a group, parents of children with diabetes were more accurate (mean delivered dose of 1.063 ± 0.276 for the 1-U dose), but the individual means ranged from 0.641 to 1.300 and coefficients of variation ranged from 5% to 33%. Only three of the seven parents could deliver 1.0 U with acceptable precision and accuracy. Conclusions. When currently available syringes are used, insulin injections of less than 20 μL (2 U of U100) have an unacceptably large error. It is recommended that, in the inpatient setting, diluted insulin be used if the prescribed dose is less than 2.0 U.

Original languageEnglish (US)
Pages (from-to)1155-1157
Number of pages3
JournalPediatrics
Volume91
Issue number6
StatePublished - 1993

Fingerprint

Insulin
Syringes
Pediatric Hospitals
Parents
Telephone
Hospital Administration
Inpatients
Injections
Pediatric Nurses
Surveys and Questionnaires

Keywords

  • diabetes mellitus
  • insulin
  • medication errors
  • syringes

ASJC Scopus subject areas

  • Pediatrics, Perinatology, and Child Health

Cite this

Casella, S. J., Mongilio, M. K., Plotnick, L. P., Hesterberg, M. P., & Long, C. A. (1993). Accuracy and precision of low-dose insulin administration. Pediatrics, 91(6), 1155-1157.

Accuracy and precision of low-dose insulin administration. / Casella, S. J.; Mongilio, M. K.; Plotnick, L. P.; Hesterberg, M. P.; Long, C. A.

In: Pediatrics, Vol. 91, No. 6, 1993, p. 1155-1157.

Research output: Contribution to journalArticle

Casella, SJ, Mongilio, MK, Plotnick, LP, Hesterberg, MP & Long, CA 1993, 'Accuracy and precision of low-dose insulin administration', Pediatrics, vol. 91, no. 6, pp. 1155-1157.
Casella SJ, Mongilio MK, Plotnick LP, Hesterberg MP, Long CA. Accuracy and precision of low-dose insulin administration. Pediatrics. 1993;91(6):1155-1157.
Casella, S. J. ; Mongilio, M. K. ; Plotnick, L. P. ; Hesterberg, M. P. ; Long, C. A. / Accuracy and precision of low-dose insulin administration. In: Pediatrics. 1993 ; Vol. 91, No. 6. pp. 1155-1157.
@article{c72df546b53a47f3bb024dc7da2145fe,
title = "Accuracy and precision of low-dose insulin administration",
abstract = "Objective. To determine the lowest dose of concentrated (U100) insulin that can be reproducibly delivered. Methods. A telephone survey was used to determine current practices in major pediatric hospitals regarding the administration of low doses of concentrated insulin. A sensitive gravitometric technique was used to determine the error in measurement of low doses of U100 insulin by pediatric nurses and parents of diabetic children. Results. A telephone survey revealed that doses as low as 0.5 or 1.0 U (5 to 10 μL) are routinely administered in pediatric hospitals. In our study of pediatric nurses, attempts to deliver 0.5, 1.0, and 2.0 U resulted in delivered doses of 0.975 ± 0.315, 1.638 ± 0.376, and 2.153 ± 0.435 U (mean ± standard deviation of the mean), respectively. The use of 0.3-mL syringes compared to 0.5-mL syringes did not improve accuracy or precision. Taken as a group, parents of children with diabetes were more accurate (mean delivered dose of 1.063 ± 0.276 for the 1-U dose), but the individual means ranged from 0.641 to 1.300 and coefficients of variation ranged from 5{\%} to 33{\%}. Only three of the seven parents could deliver 1.0 U with acceptable precision and accuracy. Conclusions. When currently available syringes are used, insulin injections of less than 20 μL (2 U of U100) have an unacceptably large error. It is recommended that, in the inpatient setting, diluted insulin be used if the prescribed dose is less than 2.0 U.",
keywords = "diabetes mellitus, insulin, medication errors, syringes",
author = "Casella, {S. J.} and Mongilio, {M. K.} and Plotnick, {L. P.} and Hesterberg, {M. P.} and Long, {C. A.}",
year = "1993",
language = "English (US)",
volume = "91",
pages = "1155--1157",
journal = "Pediatrics",
issn = "0031-4005",
publisher = "American Academy of Pediatrics",
number = "6",

}

TY - JOUR

T1 - Accuracy and precision of low-dose insulin administration

AU - Casella, S. J.

AU - Mongilio, M. K.

AU - Plotnick, L. P.

AU - Hesterberg, M. P.

AU - Long, C. A.

PY - 1993

Y1 - 1993

N2 - Objective. To determine the lowest dose of concentrated (U100) insulin that can be reproducibly delivered. Methods. A telephone survey was used to determine current practices in major pediatric hospitals regarding the administration of low doses of concentrated insulin. A sensitive gravitometric technique was used to determine the error in measurement of low doses of U100 insulin by pediatric nurses and parents of diabetic children. Results. A telephone survey revealed that doses as low as 0.5 or 1.0 U (5 to 10 μL) are routinely administered in pediatric hospitals. In our study of pediatric nurses, attempts to deliver 0.5, 1.0, and 2.0 U resulted in delivered doses of 0.975 ± 0.315, 1.638 ± 0.376, and 2.153 ± 0.435 U (mean ± standard deviation of the mean), respectively. The use of 0.3-mL syringes compared to 0.5-mL syringes did not improve accuracy or precision. Taken as a group, parents of children with diabetes were more accurate (mean delivered dose of 1.063 ± 0.276 for the 1-U dose), but the individual means ranged from 0.641 to 1.300 and coefficients of variation ranged from 5% to 33%. Only three of the seven parents could deliver 1.0 U with acceptable precision and accuracy. Conclusions. When currently available syringes are used, insulin injections of less than 20 μL (2 U of U100) have an unacceptably large error. It is recommended that, in the inpatient setting, diluted insulin be used if the prescribed dose is less than 2.0 U.

AB - Objective. To determine the lowest dose of concentrated (U100) insulin that can be reproducibly delivered. Methods. A telephone survey was used to determine current practices in major pediatric hospitals regarding the administration of low doses of concentrated insulin. A sensitive gravitometric technique was used to determine the error in measurement of low doses of U100 insulin by pediatric nurses and parents of diabetic children. Results. A telephone survey revealed that doses as low as 0.5 or 1.0 U (5 to 10 μL) are routinely administered in pediatric hospitals. In our study of pediatric nurses, attempts to deliver 0.5, 1.0, and 2.0 U resulted in delivered doses of 0.975 ± 0.315, 1.638 ± 0.376, and 2.153 ± 0.435 U (mean ± standard deviation of the mean), respectively. The use of 0.3-mL syringes compared to 0.5-mL syringes did not improve accuracy or precision. Taken as a group, parents of children with diabetes were more accurate (mean delivered dose of 1.063 ± 0.276 for the 1-U dose), but the individual means ranged from 0.641 to 1.300 and coefficients of variation ranged from 5% to 33%. Only three of the seven parents could deliver 1.0 U with acceptable precision and accuracy. Conclusions. When currently available syringes are used, insulin injections of less than 20 μL (2 U of U100) have an unacceptably large error. It is recommended that, in the inpatient setting, diluted insulin be used if the prescribed dose is less than 2.0 U.

KW - diabetes mellitus

KW - insulin

KW - medication errors

KW - syringes

UR - http://www.scopus.com/inward/record.url?scp=0027298260&partnerID=8YFLogxK

UR - http://www.scopus.com/inward/citedby.url?scp=0027298260&partnerID=8YFLogxK

M3 - Article

C2 - 8502520

AN - SCOPUS:0027298260

VL - 91

SP - 1155

EP - 1157

JO - Pediatrics

JF - Pediatrics

SN - 0031-4005

IS - 6

ER -